Psychiatric diagnosis in late adolescence and long-term risk of suicide and suicide attempt

Acta Psychiatr Scand. 2011 Dec;124(6):454-61. doi: 10.1111/j.1600-0447.2011.01752.x. Epub 2011 Aug 13.

Abstract

Objective: To investigate the associations between psychiatric diagnosis in late adolescence in an unselected population and subsequent suicide attempt and suicide during 36-year follow-up.

Method: A total of 49,321 Swedish men conscripted for compulsory military training in 1969/1970, born 1949-1951, were screened for psychiatric disorder and, if detected, diagnosed by a psychiatrist according to ICD-8. Data on suicides and suicide attempts 1971-2006 were collected in national registers.

Results: At conscription examination, 11.7% of the cohort received a psychiatric diagnosis. Among those, increased risks of suicide 1971-2006 [HR = 2.7 (2.2-3.2), 624 cases] and suicide attempt 1973-2006 [HR = 3.5 (3.1-4.0), 1170 cases] were found. The increased relative risks persisted during the follow-up period 19-36 years after examination [1989-2006 suicide HR = 2.1 (1.6-2.7), 308 cases, and 1989-2006 suicide attempt HR = 2.6 (2.1-3.1), 484 cases]. The dominant diagnostic groups, neurosis and personality disorder, were significantly associated with suicide and suicide attempt in the early as well as the late follow-up period.

Conclusion: Psychiatric diagnoses made in late adolescence predicted subsequent suicide and suicide attempt over a 36-year follow-up period. The increased relative risks were not limited to young adulthood but were also evident 18-36 years after conscription examination.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Diagnostic and Statistical Manual of Mental Disorders
  • Follow-Up Studies
  • Humans
  • International Classification of Diseases
  • Male
  • Mental Disorders* / diagnosis
  • Mental Disorders* / epidemiology
  • Mental Disorders* / psychology
  • Military Personnel / psychology
  • Military Personnel / statistics & numerical data
  • Risk Assessment / methods
  • Risk Assessment / statistics & numerical data
  • Risk Factors
  • Statistics as Topic
  • Suicide, Attempted* / psychology
  • Suicide, Attempted* / statistics & numerical data
  • Sweden / epidemiology
  • Time